The relationship between psychotherapist and client is an important part of therapy; it can even be predictive of outcomes. Yet navigating the waters between paying too much attention to the therapeutic relationship and paying too little attention to the same can be tricky. Further, the therapist–client relationship is not the only one that influences the client: Relationships the client maintains outside of therapy can play essential roles in the maintenance or change of the client's problematic behavior patterns.
What is the best way to determine the proper role of all of these relationships to maximize the likelihood of achieving the hoped-for outcomes of therapy?
In an article published in the special section "Relational Foundations of Psychotherapy" in the September 2014 issue of Psychotherapy, Wachtel describes a relational approach to therapy that he calls "cyclical psychodynamics" ("An Integrative Relational Point of View") (PDF, 76KB).
Cyclical psychodynamics is rooted in the relational perspective in psychoanalysis as well as in an integrative melding of psychodynamic, cognitive–behavioral, systemic, and experiential points of view. The goal of this approach is to both achieve corrective emotional experiences via the therapeutic relationship and foster new ways of interacting with others outside of therapy that permit the client's ongoing life experiences to themselves be key therapeutic agents.
In other words, a client's relationships both inside and outside of the consulting room make a difference in the client's treatment. For example, a client and therapist can analyze the client's personality dynamics to identify the people in that client's life who keep vicious and virtuous circles and other patterns of behavior going when a change is desired.
Much research already supports the powerful roles that the therapeutic relationship and therapeutic alliance play in the outcomes of psychotherapy. Further, life is lived in relation to other people; for therapy to be successful, change must occur in relationship contexts. Cyclical psychodynamics weds these two strong influences on therapy outcomes.
Wachtel offers examples and principles of cyclical psychodynamics for future researchers to explore, modify, and refine. The better the dynamics of relationships are understood, the better therapists will be able to help their clients live life more effectively and satisfyingly.
Citation:
Wachtel, P. L. (2014). An integrative relational point of view. Psychotherapy, 51, 342–349. doi:10.1037/a0037219
Note: This article is in the Clinical Psychology topic area. View more articles in the Clinical Psychology topic area.